Individual
DR. JUNE UPSHAW LALLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 547-1595
Mailing address
1200 W STATE ST, ROCKFORD, IL 61102-2112
(815) 490-1600
(815) 547-1595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019023799
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019023799
—
IL
Enumeration date
11/23/2005
Last updated
07/31/2015
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